Towards an anthropology of public health priorities: maternal mortality in four obstetric emergency services in West Africa

Jaffré, Yannick

doi:10.1111/j.1469-8676.2011.00190.x

Cited by 34 publications

(28 citation statements)

References 23 publications

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“…A study of obstetric care in four African hospitals illustrates the production of the ‘preferred’ account by medical records. In this context of under-resourced and frequently over-burdened health facilities, providers manipulate medical records in order to ‘rewrite’ the enactment of clinical practices (Jaffré, 2012). For example, medical providers complete the partograph, a labor-monitoring tool, after rather than during delivery.…”

Section: Literature Reviewmentioning

confidence: 99%

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Suh

2014

Social Science & Medicine

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Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal’s national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in nearly 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications.

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Section: Literature Reviewmentioning

confidence: 99%

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Suh

2014

Social Science & Medicine

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“…Nevertheless, this tool (programme)was not usedin the two above deliveries. From scholars [5][6][7] not to resort to a partogramme while helping women at births in clinics appears to be a recurrent problem in some West African countries. Jaffré [5] notes, the partogrammesare deliberatelyignored because highlighting an anomaly or a mistake while attending to childbirth make to run the risk of revealing a fault for which one may be held responsible.…”

Section: Discussionmentioning

confidence: 99%

Interpreting Maternal Death: When Underlying Causes Are Non-Medical Despite Medical Indications

Diallo¹

2017

BJSTR

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“…21 These ideas in our context mean that the infrastructure of material care -including the 22 implementation of the free CS policy -is dictated by the State, but its manner of interpretation and 23 implementation is local depending on the actors and ethos in each setting. Institutional labour and 24 delivery care, then, are inextricably linked to "social and organisational dimensions" (Jaffré 2012), 25 where to improve maternal morbidity and mortality one must understand how they are embedded 1 in the broader system. 2 As our conceptual framework indicates, quality of care is made up of both the provision of care and 3 the experience of care.…”

Section: Manipulation 10mentioning

confidence: 99%

The costs of ‘free’: Experiences of facility-based childbirth after Benin's caesarean section exemption policy

Lange

Kanhonou²,

Goufodji³

et al. 2016

Social Science & Medicine

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12As one of many similar policies in the region, in 2009 Benin launched a free c-section policy in 13 publicly funded hospitals intended to decrease the barriers to facility delivery and the heavy 14 financial burdens on women and their families. We conducted a qualitative study for eight months 15 between 2012 and 2014 to understand women's experiences of care in maternity wards. We carried 16 out semi-structured interviews with 30 women who had delivered via c-section at five hospitals. Two 17 of these hospitals became case study sites where in-depth research was undertaken that consisted 18 of participant observation in each maternity ward and 32 further interviews with women who had 19 complicated, vaginal and c-section deliveries. 20 21 Overall, women continue to pay for care, both in the form of under-the-table payments to health 22 workers and prescribed payments for services not covered by the policy, though they consider the 23 costs reasonable compared to what the charges were before. Lifting the fees has facilitated 24 conditions for midwives to alert doctors that the procedure might be needed. Partly because c-25 2 | P a g e sections are still feared by most women, in one hospital this led to some women perceiving them as 1 a threat if their labour was progressing more slowly. Implementation of the policy differed greatly 2 between the two case study hospitals. We conclude that some burdens on women's access to care 3 have been addressed but deterrents remain to the improved perception of quality of care on the 4 part of women. Findings detail how important context is to the implementation of the policy, and 5 suggest that similar user-fee removal policies should be accompanied by other measures addressing 6 staff management and quality of care. 7 8

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Towards an anthropology of public health priorities: maternal mortality in four obstetric emergency services in West Africa

Cited by 34 publications

References 23 publications

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal

Interpreting Maternal Death: When Underlying Causes Are Non-Medical Despite Medical Indications

The costs of ‘free’: Experiences of facility-based childbirth after Benin's caesarean section exemption policy

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